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Abstract
This study was designed to answer the question of whether a cervical cancer prevention
programme that incorporates a human papillomavirus (HPV) vaccine is potentially more
cost-effective than the current strategy of screening alone in South Africa. We developed
a static Markov state transition model to describe the screening and management of
cervical cancer within the South African context. The incremental cost-effectiveness
ratio of adding HPV vaccination to the screening programme ranged from US $1078 to
1460 per quality-adjusted life year (QALY) gained and US$3320-4495 per life year saved,
mainly depending on whether the study was viewed from a health service or a societal
perspective. Using discounted costs and benefits, the threshold analysis indicated
that a vaccine price reduction of 60% or more would make the vaccine plus screening
strategy more cost-effective than the screening only approach. To address the issue
of affordability and cost-effectiveness, the pharmaceutical companies need to make
a commitment to price reductions.